MEDICARE: DR. CHARNE A THOMAS DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	37224	TX
2	390200000X	Student in an Organized Health Care Education/Training Program
3	1223G0001X	General Practice Dentistry	7509	LA

General Provider Information

NPI Number	:	1043877277
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHARNE A THOMAS DDS

Provider Business Mailing Address
First Line	:	3407 CLARKSVILLE PIKE APT F
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37218-2607
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	14891 PRESTON RD STE 200
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75254-7870
Country	:	US
Telephone Number	:	972-661-2766
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/22/2019
Last Update Date	:	01/11/2024

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